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Two-year outcomes after percutaneous mitral valve repair with the MitraClip system: durability of the procedure and predictors of outcome.

Toggweiler S, Zuber M, Sürder D, Biaggi P, Gstrein C, Moccetti T, Pasotti E, Gaemperli O, Faletra F, Petrova-Slater I, Grünenfelder J, Jamshidi P, Corti R, Pedrazzini G, Lüscher TF, Erne P - Open Heart (2014)

Bottom Line: Analyse 2-year outcomes after MitraClip therapy and identify predictors of outcome.A reduction of mitral regurgitation (MR) to ≤ mild was achieved in 32 (43%) patients and to moderate in 31 (42%) patients; 16/63 (25%) patients with initially successful treatment developed recurrent moderate to severe or severe MR during the first year and only 1 patient did so during the second year.Between 1 and 2 years follow-up, clinical and echocardiographic outcomes were stable, suggesting favourable, long-term durability of the device.

View Article: PubMed Central - PubMed

Affiliation: Cantonal Hospital Lucerne , Lucerne , Switzerland.

ABSTRACT

Objective: Analyse 2-year outcomes after MitraClip therapy and identify predictors of outcome.

Methods: Consecutive patients (n=74) undergoing MitraClip therapy were included in the MitraSWISS registry and followed prospectively.

Results: A reduction of mitral regurgitation (MR) to ≤ mild was achieved in 32 (43%) patients and to moderate in 31 (42%) patients; 16/63 (25%) patients with initially successful treatment developed recurrent moderate to severe or severe MR during the first year and only 1 patient did so during the second year. At 2 years, moderate or less MR was more frequently present in patients with a transmitral mean gradient <3 mm Hg at baseline (73% vs 23%, p < 0.01) and in patients with a left atrial volume index (LAVI) <50 mL/m(2) at baseline (86% vs 52%, p=0.03). More than mild MR post MitraClip, N-terminal probrain natriuretic peptide ≥5000 ng/L at baseline, chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD) were associated with reduced survival.

Conclusions: A mean transmitral gradient <3 mm Hg at baseline, an LAVI <50 mL/m(2), the absence of COPD and CKD, and reduction of MR to less than moderate were associated with favourable outcome. Given a suitable anatomy, such patients may be excellent candidates for MitraClip therapy. Between 1 and 2 years follow-up, clinical and echocardiographic outcomes were stable, suggesting favourable, long-term durability of the device.

No MeSH data available.


Related in: MedlinePlus

Survival according to residual MR post MitraClip. Residual more than mild MR post MitraClip was associated with reduced survival, suggesting that MR should be reduced as much as possible. MR, mitral regurgitation.
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OPENHRT2014000056F2: Survival according to residual MR post MitraClip. Residual more than mild MR post MitraClip was associated with reduced survival, suggesting that MR should be reduced as much as possible. MR, mitral regurgitation.

Mentions: Survival rates were 96%, 81% and 75% at 30 days, 1 year and 2 years, respectively. Cause of death was heart failure in 10 patients, exacerbated chronic obstructive pulmonary disease (COPD) in two patients, sepsis in two patients and unknown in four patients. A total of 15 patients had an LV-EF <30% at baseline. Survival rate at 2 years was 72% in patients with functional MR and 82% in those with degenerative MR (p=0.31). Survival rate at 2 years was 73% in those with an LV-EF <30% at baseline (n=15) and 76% in those with an LV-EF ≥30% (n=59, p=0.81). Significant predictors of reduced survival were residual MR severity post MitraClip (figure 2), N-terminal probrain natriuretic peptide (NT-proBNP) ≥5000 ng/L at baseline, the presence of COPD and the presence of CKD (table 5).


Two-year outcomes after percutaneous mitral valve repair with the MitraClip system: durability of the procedure and predictors of outcome.

Toggweiler S, Zuber M, Sürder D, Biaggi P, Gstrein C, Moccetti T, Pasotti E, Gaemperli O, Faletra F, Petrova-Slater I, Grünenfelder J, Jamshidi P, Corti R, Pedrazzini G, Lüscher TF, Erne P - Open Heart (2014)

Survival according to residual MR post MitraClip. Residual more than mild MR post MitraClip was associated with reduced survival, suggesting that MR should be reduced as much as possible. MR, mitral regurgitation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4195933&req=5

OPENHRT2014000056F2: Survival according to residual MR post MitraClip. Residual more than mild MR post MitraClip was associated with reduced survival, suggesting that MR should be reduced as much as possible. MR, mitral regurgitation.
Mentions: Survival rates were 96%, 81% and 75% at 30 days, 1 year and 2 years, respectively. Cause of death was heart failure in 10 patients, exacerbated chronic obstructive pulmonary disease (COPD) in two patients, sepsis in two patients and unknown in four patients. A total of 15 patients had an LV-EF <30% at baseline. Survival rate at 2 years was 72% in patients with functional MR and 82% in those with degenerative MR (p=0.31). Survival rate at 2 years was 73% in those with an LV-EF <30% at baseline (n=15) and 76% in those with an LV-EF ≥30% (n=59, p=0.81). Significant predictors of reduced survival were residual MR severity post MitraClip (figure 2), N-terminal probrain natriuretic peptide (NT-proBNP) ≥5000 ng/L at baseline, the presence of COPD and the presence of CKD (table 5).

Bottom Line: Analyse 2-year outcomes after MitraClip therapy and identify predictors of outcome.A reduction of mitral regurgitation (MR) to ≤ mild was achieved in 32 (43%) patients and to moderate in 31 (42%) patients; 16/63 (25%) patients with initially successful treatment developed recurrent moderate to severe or severe MR during the first year and only 1 patient did so during the second year.Between 1 and 2 years follow-up, clinical and echocardiographic outcomes were stable, suggesting favourable, long-term durability of the device.

View Article: PubMed Central - PubMed

Affiliation: Cantonal Hospital Lucerne , Lucerne , Switzerland.

ABSTRACT

Objective: Analyse 2-year outcomes after MitraClip therapy and identify predictors of outcome.

Methods: Consecutive patients (n=74) undergoing MitraClip therapy were included in the MitraSWISS registry and followed prospectively.

Results: A reduction of mitral regurgitation (MR) to ≤ mild was achieved in 32 (43%) patients and to moderate in 31 (42%) patients; 16/63 (25%) patients with initially successful treatment developed recurrent moderate to severe or severe MR during the first year and only 1 patient did so during the second year. At 2 years, moderate or less MR was more frequently present in patients with a transmitral mean gradient <3 mm Hg at baseline (73% vs 23%, p < 0.01) and in patients with a left atrial volume index (LAVI) <50 mL/m(2) at baseline (86% vs 52%, p=0.03). More than mild MR post MitraClip, N-terminal probrain natriuretic peptide ≥5000 ng/L at baseline, chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD) were associated with reduced survival.

Conclusions: A mean transmitral gradient <3 mm Hg at baseline, an LAVI <50 mL/m(2), the absence of COPD and CKD, and reduction of MR to less than moderate were associated with favourable outcome. Given a suitable anatomy, such patients may be excellent candidates for MitraClip therapy. Between 1 and 2 years follow-up, clinical and echocardiographic outcomes were stable, suggesting favourable, long-term durability of the device.

No MeSH data available.


Related in: MedlinePlus